Background: In Austria, approximately one in five adults is affected by mental illness annually. The most common conditions are depression (10%), anxiety disorders (7%), and substance use disorders (12%). Screening using questionnaires in the primary care setting could help identify affected individuals and enable timely treatment. Since screening can also cause harm, benefits and potential risks must be carefully weighed. The aim of this report was to systematically analyse the evidence for screening the three most common mental illnesses and guideline recommendations, describe screening methods, and analyse implications of potentially implementing a screening programme.

Methods: A systematic search for HTA reports, systematic reviews, and guidelines was conducted in five databases, along with additional hand searches. Literature selection was performed blinded, by two authors. Quality assessment was conducted using ROBIS for systematic reviews and AGREE-II for guidelines.

Results: Nine systematic reviews and 28 guidelines were included. Four out of five systematic reviews on depression screening and two reviews on anxiety disorders found insufficient evidence for effectiveness. No effectiveness studies could be identified for alcohol and drug use screening. Nevertheless, most guidelines recommended screening, particularly for risk groups. Of 101 identified screening instruments, 17 met the inclusion criteria. Implementation would require consideration of numerous factors, including definition of target groups and screening pathways, staff training, and ensuring treatment availability. Barriers identified included stigmatisation, treatment costs, and time constraints.

Conclusion: Despite both screening questionnaires and treatment options being available, there is currently a lack of direct evidence for screening benefits. The introduction of a screening programme should be carefully weighed against alternatives for improving mental health care (e.g. adequately publicly funded treatment options, destigmatisation).